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Management of Pediatric Upper System Problems: Conjunctivodacryocystorhinostomy

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Pediatric Oculoplastic Surgery

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Abstract

The conjunctivodacryocystorhinostomy (CJDCR) procedure, as originally described by Jones, involves the use of a Pyrex tube to create a fistula from the conjunctiva to the nasal mucosa. For adults, this procedure is considered the standard method of treatment for epiphora due to significant obstruction of the canaliculi or internal common punctum. In contrast, most oculoplastic surgeons have not advocated CJDCRs for pediatric patients with similar problems, because this procedure is associated with a fairly high frequency of complications. Although bypass tubes require considerable maintenance and frequent revisions, because no useful alternative procedure exists, the CJDCR remains the only reliable method of controlling epiphora due to extensive canalicular obstruction in young patients.

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Authors and Affiliations

  1. Oculoplastic Service, Wills Eye Hospital, Department of Ophthalmology, Jefferson Medical College and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Scott M. Goldstein MD

  2. Oculo-facial Plastic Surgeon, Tri-County Eye Physicians and Divisions, Vantage EyeCare, Philadelphia, PA, USA

    Scott M. Goldstein MD

  3. The Children’s Hospital of Philadelphia and The Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania, Philadelphia, PA, USA

    James A. Katowitz MD, FACS

Authors
  1. Scott M. Goldstein MD
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  2. James A. Katowitz MD, FACS
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Correspondence to Scott M. Goldstein MD .

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Editors and Affiliations

  1. Professor Emeritus of Ophthalmology and Director of Oculoplastic and Orbital Surgery, The Children’s Hospital of Philadelphia and The Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania, USA

    James A. Katowitz

  2. Associate Professor of Clinical Ophthalmology and Director of the Oculoplastic and Orbital Surgery Fellowship Program, The Children’s Hospital of Philadelphia and The Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    William R. Katowitz

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Goldstein, S.M., Katowitz, J.A. (2018). Management of Pediatric Upper System Problems: Conjunctivodacryocystorhinostomy. In: Katowitz, J., Katowitz, W. (eds) Pediatric Oculoplastic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-60814-3_30

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  • DOI: https://doi.org/10.1007/978-3-319-60814-3_30

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60812-9

  • Online ISBN: 978-3-319-60814-3

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